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Obstetrics & Gynaecology > Gynaecology - Sexually Transmitted Infections (Discharge) > Flashcards

Gynaecology - Sexually Transmitted Infections (Discharge) Flashcards

1
Q

Genital Infections:

  • Discharge
  • Lesions
A

Need to look at the following:

  • Description, pH, Microscopy - Discharge
  • Pain, What does it look like - Lesions
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2
Q

Genital Infections that cause discharge?

A
  • Bacterial Vaginosis
  • Trichomoniasis
  • Candidiasis
  • Neisseria Gonorrhoea
  • Chlamydia Trachomatis
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3
Q

Genital infections that cause lesions?

A
  • Trepomema Pallidum - Spirochaete bacterium, can cause syphilis
  • Genital Herpes
  • Condyloma Acuminata - HPV, anal neoplasia
  • Haemophilus Ducreyi - Chancroid
  • Lymphogranuloma venereum - Caused by 3 serovars of Chllamydia Trachomatis, not caused by same bacteria that causes genital chlamydia
  • Granuloma Inguinale - Known as Donovanosis caused by Klebsiella granulomatis
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4
Q

Bacterial Vaginosis - Gardnerella

A

Bacterial Vaginosis - Gardnerella:

  • Description: Watery/thin/grey, white - FISHY ODOUR
  • pH - >4.5
  • Microscopy - Clue cells = epithelial cells covered in blue or purple coating
  • Treatment - Metronidazole
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5
Q

Genital Infections that can cause discharge - Trichomoniasis

A

Trichomoniasis:

Description - Green frothy discharge

pH - >4.5

Microscopy - Motile trichomonads with flagella

Treatment - Metronidazole -Treat partner

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6
Q

Bacterial Infections that cause discharge - Candidiasis?

A

Candidiasis: (Discharge)

Discription - Thick, White

pH - < 4.5 (low pH is unique)

Microscopy - KOH prep with pseudohyphae

Treatment - Topical azoles or oral fluconazole

Risk Factors - Recent anti-biotics, diabetes, oral contraceptives

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7
Q

Genital Infections that cause discharge:

Neisseria Gonorrhea

Chlamydia Trachomatis

A

Neisseria gonorrhea/Chlamydia trachomatis:

Description - Prurulent discharge

Microscopy - Gram negative diplococci (GC)/ Gram negative intracellular (Chlamydia)

Treatment - Ceftriaxone (GC): +Azithromycin or doxycycline (Chlamydia), usually treat both

Presentation - Sick, (pain/nausea/vomitting/fever) and cervical discharge/cervical motion tenderness

GonorrheaChlamydia - PID: Pelvic inflammatory disease

Complications of PID - Infertility, Ectopic pregnancy, Fitz-Hugh-Curtis syndrome: involving liver capsule inflammation leading to the creation of adhesions: Can cause upper right quadrant pain

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8
Q

Genital Infections that cause lesions:

A

Genital Infections that cause Lesions:

  • Treponema pallidum
  • Genital Herpes
  • Condyloma acuminata
  • Haemophilus ducreyi
  • Lymphogranuloma venereum (Chlamydia)
  • Granuloma inguinale (Klebsiella or Calmmatobacterium aka Donovanosis
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9
Q

Genital Infections that cause lesions:

‘Painless’

A
  • Treponema pallidum
  • Condyloma acuminata
  • Granuloma inguinale
  • Klebsiella Donavanosis
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10
Q

Genital Infections that cause lesions:

‘Painful’

A

Painful:

  • Genital Herpes
  • Haemophilus ducreyi (Chancroid)
  • Lymphogranuloma venereum (Chlamydia trachomatis)
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11
Q

Genital Infections that cause lesions:

‘No pain’

A

Painless:

  • Treponema pallidum (Syphyllis)
  • Condyloma acuminata (HPV)
  • Granuloma inguinale (Klebsiella)
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12
Q

Genital Infections that cause lesions:

‘No pain’

A
  • Treponema pallidum (Syphillus) - Ulcer with well-defined borders
  • Condyloma acuminata (HPV) - Skin coloured papules (genital warts)
  • Granuloma inguinale(Klebsiella) - sharply demarcated ulcer with beefy red granulation tissue
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13
Q

Genital Infections that cause lesions:

‘No pain’

Syphilis the great imitator?

A

Syphilis - the great imitator:

  • Primary
    • Painless chancre
  • Secondary
    • Condyloma lata
    • Rash on palms and soles
  • Tertiary
    • Gummas - is a soft, non-cancerous growth resulting from the tertiary stage of syphilis. It is a form of granuloma.
    • Aortitis
    • Neurosyphilis
    • Argyll Robertson pupil - usually bilateral and characterised by small, irregular pupils; the size of the pupils may be unequal; absence of the light reflex; a prompt accommodation reflex; pupils slowly dilate with mydriatics.
  • Diagnosis: requires two tests - Venereal Disease research lab (VDRL) and the T.pallidumpassive agglutination(TP-PA)
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14
Q

Genital Infections that cause lesions:

‘No pain’

Condyloma acuminata HPV (Genital warts)

Granuloma inguinale Klebsiella

A
  • Condyloma acuminata HPV (Genital warts) - Skin coloured papules
  • Granuloma inguinale Klebsiella - demarcated ulcer, beeffy red granulation
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15
Q

Genital Infections that cause lesions:

‘No pain’

Granuloma inguinale

A

Sharpley demarcated ulcer with beefy red granulation tissue

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16
Q

Genital Infections that cause lesions:

Painful

A

Genital Herpes - Vesicles

Haemophiilus ducreyi - Chancroid - Ulcer withh yellow/grey/exudate

Lymphogranuloma venereum - Chlamydia Ulcer/swollen tender/lymph nodes

Obstetrics & Gynaecology (57 decks)

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